Abstract
BackgroundYoung people face many barriers in accessing health services that are responsive to their needs. The World Health Organization has led a call to develop services that address these barriers, i.e. youth-friendly health services. Addressing the needs of young people is one of the priorities of Foundation fami, an organisation working in collaboration with the Swiss Federal Department of Development and Cooperation and Geneva University Hospitals to develop quality family medicine services in Bosnia and Herzegovina. This paper describes the design of a trial to assess the effectiveness of a multifaceted intervention involving family medicine teams (primary care doctors and nurses) to improve the youth-friendliness of family medicine services in Bosnia and Herzegovina.Methods/DesignThis is a stratified cluster randomised trial with a repeated cross-sectional design involving 59 health services in 10 municipalities of the canton of Zenica in Bosnia and Herzegovina. Municipalities were the unit of randomisation: five municipalities were randomised to the intervention arm and five to a wait-list control arm. Family medicine teams in the intervention arm were invited to participate in an interactive training program about youth-friendly service principles and change processes within their service. The primary outcome was the youth-friendliness of the primary care service measured using the YFHS-WHO + questionnaire, a validated tool which young people aged 15 to 24 years complete following a family medicine consultation.A total of 600 young people aged 15 to 24 years were invited to participate and complete the YFHS-WHO + questionnaire: 300 (30 per municipality) at baseline, and 300 at follow-up, three to five months after the training program.DiscussionThe results of this trial should provide much awaited evidence about the development of youth-friendly primary care services and inform their further development both in Bosnia and Herzegovina and worldwide.Trial registrationAustralian New Zealand Clinical Trials Registry_ ACTRN12610000142033
Highlights
Young people face many barriers in accessing health services that are responsive to their needs
Youth-friendly family medicine services Much of the current disease burden in young people is related to health-compromising behaviors and psychosocial problems including mental disorders, tobacco, alcohol and other substance use, accidents and injuries, sexually transmitted diseases and unwanted pregnancies
Studies in high income countries have shown that most young people, including those who engage in health compromising behaviors, visit a family doctor at least once a year (McPherson 2005; Murdoch and Silva 1996; Elliott and Larson 2004; Jeannin et al 2005; Haller et al 2008)
Summary
The results of this trial should provide much awaited evidence about the development of youth-friendly primary care services and inform their further development both in Bosnia and Herzegovina and worldwide.
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